Guideline for implementation of patient self-testing and patient self-management of oral anticoagulation
International consensus guidelines prepared by International Self-Monitoring Association for oral Anticoagulation (ISMAA).
The Importance of Pharmacogenetics
Utilizing the correct intensity of a vitamin K antagonist (VKA) and maintaining the patient in the therapeutic range are two of the most important determinants of its effectiveness and safety. Therapeutic efficacy can be influenced by physiologic and pharmacologic factors such as drugs or illnesses that affect the pharmacokinetics or pharmacodynamics of the VKA, dietary or GI factors that affect the availability of vitamin K1, physiologic factors that affect the synthetic or metabolic fate of the vitamin K-dependent coagulation factors, and the ability of the health-care provider to make appropriate dosage and follow-up decisions....
Modern life with anticoagulants
Oral anticoagulant therapy (OAT) with warfarin has been used for more than 60 years to prevent blood from clotting inside the heart or in blood vessels. In spite of a wide spectrum of newer drugs available on the market, scientific studies with warfarin has repeatedly proven this drug as most effective for several applications and it has also been verified as a drug with remarkably few side effects. ...
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The Importance of stable therapeutic INR in oral anticaogulation
Valve thrombosis, thromboembolism and bleeding together account for approximately 75% of the complications experienced by patients with prosthetic heart valves. Not all are prosthesis-related, as there is a ‘background incidence’ of stroke/TIA and major bleeding in the general population, rising gradually with age. Nevertheless, despite published guidelines on anticoagulation management, many events occur as the result of under-anticoagulation, over-anticoagulation or very variable anticoagulation.
Optimal management of anticoagulation with atrial fibrillation
It is projected that 7.5 million individuals will have atrial fibrillation by the year 2020 in the United States alone. The prevalence of atrial fibrillation increases with age as does the risk of stroke. In a meta-analysis of the early trials in atrial fibrillation, vitamin K antagonists were shown to reduce the risk of stroke by 68%.
INR Self-Management: A promising tool to achieve low complication rates after mechanical heart valve replacement
During recent decades, heart valve replacement has become a frequent intervention in cardiovascular medicine. Mechanical heart valves account for approximately 70 % and biological heart valves for approximately 30 % of totally implanted heart valves. Because biological heart valves are durable for only 8 to 12 years in the aortic position and only 6 to 8 years in the mitral position, these implants are restricted to elderly patients.
INR-Selfmanagement: A promising tool to achieve low complication rates after mechanical heart valve replacement
During recent decades, heart valve replacement has become a frequent intervention in cardiovascular medicine. Mechanical heart valves account for approximately 70 % and biological heart valves for approximately 30 % of totally implanted heart valves. Because biological heart valves are durable for only 8 to 12 years in the aortic position and only 6 to 8 years in the mitral position, these implants are restricted to elderly patients.
Quality of life and self-monitoring: CVD prevention in practice
Engaged patients with a good knowledge of their own disease are open to prevention and are also active in managing their own disease.